Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00667
AI DATE ISSUED: 10/5/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S114BA-13700
SITE ADDRESS: 16280 SW COPPER CREEK DR
SUBDIVISION: COPPER CREEK STAGE 4 ZONING: R -7
BLOCK: LOT: 102 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
>
GAS OUTLETS:
10000 cfm:
Remarks: Replace gas furnace.
Owner: FEES
LARKINS, JANIS L + SHARON A Description Date Amount
16280 SW COPPER CREEK DR [MECH] Permit Fee 10/5/200z $72.50
TIGARD, OR 97224 [TAX] 8% State Surchart 10/5/200L $5.80
Phone: Total $78.30
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97223 REQUIRED INSPECTIONS
Phone: 503 Heating Lint lnsp
Final Inspection
Reg #: LIC 76359
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503) - 699. p
Iss d By: 0 .1 �A ! / Permittee Signature; tre ..* of i.
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Oct 04 04 01:56p PAM DALBY 503 - 598 -02 ?O p.2
e Crpl‘ll ® . .
FOR USE ONLY
M.echanic3l "Perm1 T,p�liie4.10 — . �O
Received if _/ * PerrutN frf f 4 7
City- of Tigard 1 2004 Rec /d 'j
I 25 SW Hal! Blvd , T••gard, OR 9722�C Plan Review Other Pc crut
Phone 503 639 4'.71 Fax. 503.598 96 O F 1 IG ARD Lkas e Date, ' luri ( E7 See P age 2 for
lrspect.on Li-e. 503 639 4175 � ` ' I
Date Read ytBy I Supplemental Ir- Icrmation
I VI
No:.tiedlM lCj • Internet •.tww c. egard or us BUILDING D SIO
: ,. j `d' _ _ . ,s '- `� Y�,�Ft�� :i : :7 :; .cd; • i 5 _;. ,,,r .s.:. 5::.: 'I . c:oi IVIERCTAL ='BEET SCHED•CEE - USE CHECKLIST
.T t ,
• - Mechanical permit fees' are based on the value of the tuns k
❑ e\c cor'StRICaO❑ ddit:on/alteration/replacenent I performed. Indicate the value (rounded to the neares: dollar) of 31.
❑ Demolition ❑ Other
mechanical materials, equipment, labor, oi,erhead, and prof)'
4 IT] Value. S
f :'' :.a;'• :,-, : , a J�~'knit; 'Cr 0 O COIV RIJ I TON +' •,' DEI .OIA.[`.EQUIPMENT /SYSTEMSFEES'
and farmly dwelling ❑ Commercial /industrial ❑ Accessory budding For special information use checklist
( hl.nu :am.ly El Master builder ❑ Other• Descnp; ion ' Qty Ea ! r °;"
s. .; ., cx' Heatin g
, _ e ATI , ' . : ; . •. g coolln
- •'•,.TO�B�'SIT;�II�FOR t �!I ' • C S .,..,..; ...
: ; , Air conditioning or heat comp
/ , t-, ,S I 14
Jon site add: eSS /� y 1 (requites site plan showing placement)
Y (J 7 Fumace 100,000 BTU (ductslvc I / I la 00
C,ryrSt2ic'ZIP' Furnace 100,000+ BTU (ducts/veats) I 17 c,0 I
Suite oidg,apt no
Protect name. Gas heat pump' 14.00
Duet work 1 00
•
Cross s:;eeb'direuions to job site. Hydronic hot water system I I ■ 4 30 1
Residential boiler (radiator or ) 4 00
hydronic)
Unit heaters (fuel -type, not electnc),
in -wall, 10.00
-wall, in -duct, suspended, etc
Flue /vent for any of above f 10 00 I
Subd:viston.
Lot no.. Other I 10 00 _
Other fuel appliances
Tax rap %pyrcelno . „ �, Wat I 10 OC'
: — -
I
6'. / "c3=1.''-t- ' 'FI `4:",:n, t r: •'tom'•; :;. Water heater f I (U'JO
;i ' . ';+ . • CTP - 1 4 . E N .Y. ` r, N5' ,4FF � -�' , r t : :; ::.; ll:y ..1i.n .;, as
h `
; t, ; _, ., a .;,`Yp :=P.2-.1'-
, -.,.. G fireplace
� ��( A / Flue vent for water heater or gas
4 t � j llf Ali S \ Fireplace 00 —
i Log lighter (gas) I 10 00
Wood /pellet stove I I 10 00
I Wood fireplace /insert I I 10 00
Chimney /liner /flue /vent '.00'0 1
rROP•E .> Y x .,. , f t ' <T ; T; z4- x -t•` .. . .. a : , Other. I C on
•.t ':' �i � .��, , :.., • : �- `.ni,Vi�',I��12•hj''r` :�} �'u4; `1. ,.Fd.. F "�''r•' S., � , r • r�`
I.
I / „ � '/J . I Environmental exhaust and ventilation
Name L(� Il /'V Range hood /other kitchen I i
10 00
Address W�� �n $+L/V 10 DO
r Clothes dryer exhaust
City /Sta,ei ZT- l -, -(-' S:ngle -duct exhaust (bathrooms,
/ r 9 ' ? Fax: ( ) toilet compartments, ur,lity
rooms) I 5 50
- Phone I. 523 (� r ;� .� v Fair , , -v p_ Attic /crawlspace fans I 10 O I
W 1 I IOOU I
h z,.yi ®'4 . tir ; +r ::;• a p�!��{'Q�(r PER$,Q` °'ti I t
! t ,'T'' I -`, ' ; t `c•. i r r . „ ^,. : ' :• ' (..t r —. .,.. II Other I
' 1
Business name. Fuel piping —,
JO� 55,40 for first four; 51.00 for each additional
Contact name t �� I Furna etc ( I
ll Address Gas heat pump
Wail /suspended /unit heater 1
C ryrStatc!Z� I
Phone ) i Watei heater
�U j ) _5"7-1 o /70 I • Fireplace
( 7 0,2q ��t1� Fax (
I Range
E-mail r r.
r n_ � +•, r'i� '^ ^'„i�'Cp'. � a� "'- r }° < #�' . ; %��j, Sihi Barbecue
�' •5 :� M1-'?.1 �y 3'_'Y�� :-r. 'C.�- '.1..*N"'Z +” ` ..'Z'2,.i :�, :i; 7'nv " ., r:. - °. ,
` -'' E;,�r'�i;J!',{,'�tir�' ^• its:'. ��.-,'' >�•e,r :'�,''u'k`'_- �'.•'.�,`,•� '.;rev` e•' . Clothes dryer (gas) \ r__________
` Business name: C__,) /u y y 6 /LL- /1t4 - 7 - 7./(o '-,-- CO e 1r "L/4. ,
3 b 3 9 7 t 1
..a :; a • >yC_ A\' 1CAL PE Other' I
.�ddress �,.;
� 4 � }� I ,• ,• i Subtotal
C •ry' %S :a;erZLP / / G A -41', a2-• .7� - � Minimum permit f ee ($72 50)
Phone. r ;
G a 9. �� O T t Fa • b 3) _59 g' O c2 7d I Plan review (25% of permit fee)
State surcharge (8% of permit fee)
I CCB Ito,. '] f TOTAL PERMIT FEE I
This permit application expires if a permit is not obtained w'thin iSO
:�.rhonzed s;gnature. days after it has been accepted as complete
e )„.. 4 / \ Date' 1/{ JJJ r �/ o t ' Fee methodology set by in-County Bui•d'•ng industry Se r. ice Board
440.46177 ii 1 /02iCOr.v ai
i 'BwidmS�Yc^-cts`,htL•C- PcrnaAPp doe 12 /OJ
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: "(503)'639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Dat Requested / b (a— AM PM BUP
Location / ? 0 A/ � /l�.e Suite j ace ci - 66e 7
Contact Person f Ph ( )(q '— a7O PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC t "
Footing
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear t — LJL J S . a�) 13'7 P� ,
Framing
Insulation
Drywall Nailing
Firewall M 5- 9 4
Fire Sprinkler
Fire Alarm
Susp'd Ceiling t,
Roof � 1 D 0
Other:
Final
PASS PART FAIL
\‘A
PLUMBING
Post & Beam
-Under Slab ` 1 \ i.� 'L Rough -In N\ \A\A 1�� � I ' `Q @)/ 6
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL Y `- k, n
Post & Beam Ajltr
Rough -In fl
Gas Line
Smoke Dampers
PART FAIL
EL CTRICAL < .
Service
Rough -In
UG /Slab
Low Voltage ��\ 1'V . r
Fi��arm
❑ Reinspection fee of $ required before next inspection. Pay atCity Hall, 13125 SW Hall Blvd.
•;4 PART FAIL
SITE Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA 4_ 2 d
Approach/Sidewalk Date /
I nspector - Ext
Other:
Final DO NOT REMOVE this inspection recor ' from the Jo site.
PASS PART FAIL